中国内镜杂志2026，Vol.32Issue(5)：44-50,7.DOI:10.12235/E20250389
胆总管结石患者内镜逆行胰胆管造影术后复发的影响因素分析
Analysis of influencing factors of recurrence after endoscopic retrograde cholangiopancreatography in patients with calculus of the common bile duct
摘要
Abstract
Objective To analyze the influencing factors of recurrence after endoscopic retrograde cholangiopancreatography(ERCP)in patients with calculus of the common bile duct,and to construct a regression equation to analyze its predictive value,so as to provide a reference for the prevention of postoperative recurrence.Methods A total of 256 patients with calculus of the common bile duct who underwent ERCP in this hospital from January 2020 to March 2024 were collected.All patients were followed up for one year.According to whether there was recurrence,they were divided into the recurrence group(53 cases)and the non-recurrence group(203 cases).Univariate and multivariate logistic regression models were used to analyze the independent risk factors for recurrence after ERCP in patients with calculus of the common bile duct,and regression equation was constructed to analyze their predictive value for postoperative recurrence in patients.Results History of cholecystectomy((OR^)=1.758,95％CI:1.096～2.819),common bile duct diameter≥15 mm((OR^)=2.056,95％CI:1.042～4.060),biliary stricture((OR^)=1.626,95％CI:1.084～2.439),parapillary diverticulum((OR^)=1.885,95％CI:1.009～3.523),number of stones≥3((OR^)=1.694,95％CI:1.103～2.602),papillary sphincterotomy((OR^)=1.904,95％CI:1.033～3.510)and the postoperative drainage method of biliary and pancreatic duct stent((OR^)=1.800,95％CI:1.120～2.893)were independent risk factors for recurrence after ERCP in calculus of common bile duct patients(P<0.05).Regression equation:Logit(P)=8.977+history of cholecystectomy×0.564+common bile duct diameter≥15 mm×0.721+biliary stricture×0.486+parapapillary diverticulum×0.634+number of stones≥3×0.527+papillary sphincterotomy×0.644+postoperative drainage method of biliary and pancreatic duct stent×0.588(P<0.05).When logit(P)>0.26,the area under the curve(AUC)was 0.860,the sensitivity was 81.13％,and the specificity was 81.28％(95％CI:0.811～0.900).Conclusion The risk factors for recurrence after ERCP in patients with calculus of the common bile duct include a history of cholecystectomy,a common bile duct diameter of≥15 mm,biliary stricture,a parapillary diverticulum,a number of stones≥3,the papillary sphincterocomy,and the postoperative drainage method being biliary and pancreatic duct stents.Clinical attention should be paid.关键词
胆总管结石/内镜逆行胰胆管造影术(ERCP)/复发/影响因素/回归方程Key words
calculus of the common bile duct/endoscopic retrograde cholangiopancreatography(ERCP)/recurrence/influencing factors/regression equation分类
医药卫生引用本文复制引用
陈亚,洪锡祥,陈祝明,刘绍文,方剑..胆总管结石患者内镜逆行胰胆管造影术后复发的影响因素分析[J].中国内镜杂志,2026,32(5):44-50,7.基金项目
安庆市科学技术局(No:2022Z3013) （No:2022Z3013）
